Evidence map›Paper›PMID 41770058›Full record

SynthesisEFORT open reviews2026

Does being male represent a risk factor for DDH treatment? A systematic review.

Maurizio De Pellegrin, Federico Sinigaglia, Lorenzo Marcucci, Nicola Guindani, Simone Romeni, Laura Mangiavini

Abstract readSystematic Review
In one paragraph

Synthesis in EFORT open reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Maurizio De PellegrinPediatric Orthopedic Unit, Piccole Figlie Hospital, Parma, Italy.
Federico SinigagliaOrthopedic Residency Program, University of Milan, Milan, Italy.
Lorenzo MarcucciOrthopedic Residency Program, University of Verona, Verona, Italy.ORCID https://orcid.org/0009-0006-3511-1749
Nicola GuindaniDepartment of Orthopedics, ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy.
Simone RomeniModular Implantable Neurotechnologies (MINE) Laboratory, Vita-Salute San Raffaele University & Scuola Superiore Sant'Anna, Milan, Italy.
Laura MangiaviniDepartment of Biomedical Sciences for Health, University of Milan, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Although female sex is a known risk factor for developmental dysplasia of the hip (DDH), limited data exist regarding sex-specific differences in treatment outcomes. This study aimed to analyze whether being male represents a risk factor for unfavorable outcomes in DDH treatment. Methods: A systematic search was conducted across PubMed, Embase, and Cochrane Library databases to identify studies comparing DDH treatment outcomes between males and females. The review adhered to PRISMA and PROSPERO guidelines, including studies published from 1995 to 2023. Results: Out of 327 initially identified articles, 23 met the selection criteria, describing 10,307 total DDH cases (5,296 males; 4,700 females). Only six articles clearly reported outcomes stratified by sex. Our analysis focused on establishing whether male sex was a risk factor for Pavlik harness failure and the incidence of avascular necrosis (AVN). For Pavlik harness failure, the meta-analysis included 93 male and 630 female hips, with failure in 32 male (34%) and 148 female (23%) hips. The meta-analysis indicated a significant association between male sex and Pavlik harness failure (P = 0.03). Pooling data from relevant articles for AVN showed that AVN occurred in 32 out of 91 male (35%) and 77 out of 355 female (22%) hips, suggesting a significant association between male sex and AVN (P = 0.008). Conclusions: Overall, male patients exhibited a higher failure rate in Pavlik harness treatment. The pooled analysis of AVN data further suggests that males may demonstrate a poorer prognosis compared to female patients in DDH treatment.

Indexed as

avascular necrosisAVNDDHfailure ratemale sexPavlik harnessrisk factorstreatment

Identifiers

PMID41770058
PMCPMC12974768

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.